MEDICAL MANAGEMENT OF INTERSTITIAL ECTOPIC PREGNANCY WITH METHOTREXATE–MIFEPRISTONE COMBINATION: A CASE REPORT.

Abstract

Interstitial ectopic pregnancy (IEP) is a rare condition with a high risk of rupture and hemorrhage. While surgical intervention is the gold standard, this case highlights successful medical management using methotrexate combined with mifepristone, offering an alternative to surgery and its related complications. A 30-year-old primigravida presented with abdominal pain and per vaginal spotting. Transvaginal ultrasound with doppler confirmed an 8+1weeks interstitial pregnancy. Despite counselling on surgical options, the patient preferred medical management. A multi-dose methotrexate protocol with leucovorin rescue, supplemented by mifepristone, led to a complete resolution. This case demonstrates the potential of a combined methotrexate-mifepristone regimen in managing IEP non-surgically. The main aim of our medical management approach was to reduce the morbidity and complication associated with surgical management thus emphasising the need for further investigation into its efficacy.